Hay Fever (Nasal Allergies)  

This Care Guide Covers:

  • An allergic reaction of the nose (called allergic rhinitis)
  • An itchy nose, clear discharge and sneezing is common

If not, see these topics
  • Does not look like hay fever. See COLDS.
When to Call Your Doctor

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen
  • Lots of coughing
  • Sinus pain (not just congestion) does not go away with allergy medicines. (NOTE: Sinus pain is around the cheekbone or eyes.)
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Hay fever symptoms make it hard to go to school or do normal activities. (NOTE: Taking allergy medicine for 2 days has not helped.)
  • Diagnosis of hay fever has never been made by a doctor
  • Year-round symptoms of nasal allergies
  • Snoring is a frequent problem
Parent Care at Home If
  • Hay fever
Causes & Health Information

Symptoms

  • Clear nasal discharge with sneezing, sniffing, and itching of nose (100%)
  • Eye allergies (itchy, red, watery and puffy) also can occur (70%)
  • Ear and sinus congestion or fullness can occur
  • Throat can also feel scratchy or have a tickly feeling at times
  • Itchy ear canals, itchy skin or hoarse voice sometimes also occur
  • Symptoms happen during pollen season
  • Same symptoms during the same month of the last year
  • Past diagnosis by a doctor is helpful
  • No fever

Causes

  • Hay fever is an allergic reaction of the nose and sinuses. It is a reaction to an inhaled substance (called an allergen). Most often, this is a pollen.
  • Grass, trees, weeds and molds are the most common pollens.
  • Allergens can also be from cats, dogs, horses, rabbits and other animals.
CARE ADVICE FOR HAY FEVER

  1. What You Should Know:
    • Hay fever is very common. It happens in about 15% of children.
    • Nose and eye symptoms can be controlled by giving allergy medicines.
    • Pollens are in the air every day during pollen season. So, allergy meds must be given daily. They need to used for 2 months or longer during pollen season.
    • Here is some care advice that should help.
  2. Allergy Medicines:  
    • Allergy medicines are called antihistamines. They are the drug of choice for nasal allergies.
    • They will help control the symptoms. These include a runny nose, nasal itching and sneezing.
    • Benadryl or Chlorpheniramine (CTM) products are helpful. No prescription is needed. They need to be given every 6 to 8 hours. See Dose Tables.
    • The bedtime dosage is especially important for healing the lining of the nose.
    • The key to control is to give allergy meds every day during pollen season.
  3. Cetirizine (Zyrtec) or Loratadine (Claritin):
    • Loratadine and Cetirizine are long-acting allergy medicines. No prescription is needed.
    • Advantage: Causes less sedation than older allergy meds such as Benadryl and chlorpheniramine. They are long-acting and last up to 24 hours.
    • Dose:
    • AGE 2- 6 years old, discuss with your child's doctor. If approved, give 2.5 mg (2.5 ml or 1/2 teaspoon) of liquid syrup. Use once daily in the morning.
    • AGE 6-12 years old, give 5 mg chewable tablet once daily in morning.
    • AGE: 12 years and older, give 10 mg tablet once daily in morning.
    • Downside: Doesn't control hay fever symptoms as well as older allergy medicines. Also, sometimes will have breakthrough symptoms before 24 hours. If that happens, you can give a single dose of Benadryl or CTM.
    • Cost: Ask the pharmacist for a store brand. Reason: Costs less than Claritin or Zyrtec brand.
  4. Nasal Washes to Wash Out Pollen:
    • Use saline nose drops or spray. This helps to wash out pollen or to loosen up dried mucus. If you don't have saline, you can use warm tap water.
    • STEP 1: Put 3 drops in each nostril.
    • STEP 2: Blow each nostril out while closing off the other nostril. Then, do the other side.
    • STEP 3: Repeat nose drops and blowing until the discharge is clear.
    • How often: Do nasal washes when your child can't breathe through the nose. Also, do them if the nose is very itchy.
    • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
    • Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of warm water.
    • Other option: Use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
  5. Eye Allergies:  
    • For eye symptoms, wash off the face and eyelids. This will remove pollen or any other allergic substances.
    • Then put a cold wet washcloth on the eyes.
    • Most often, an allergy medicine given by mouth will help the eye symptoms. Sometimes, eye drops are also needed.
    • Antihistamine Eye Drops - Ketotifen (1st Choice):
    • Ketotifen eye drops are a safe and effective product. Examples are Zaditor or Alaway. No prescription is needed.
    • Dose: 1 drop every 12 hours.
    • For severe allergies, use ketotifen eyedrops every day during pollen season. This will give the best control.
    • Antihistamine/Vasoconstrictive Eyedrops (2nd Choice):
    • Dose: 1 drop every 8 hours
    • Ask your pharmacist to suggest a brand. Some brand names are Naphcon A, Opcon A, or Visine A.
    • Do not use for over 5 days. (Reason: Will cause red eyes from rebound effect).
    • Downside: Doesn't work as well as Ketotifen eye drops.
  6. Wash Pollen Off Body:
    • Remove pollen from the hair and skin with shampoo and a shower. This is especially important before bedtime.
  7. What to Expect:
    • Since pollen allergies recur each year, learn to control the symptoms.
  8. Pollen - How to Reduce the Pollen Your Child Breathes:
    • Pollen is carried in the air.
    • Keep windows closed in the home, at least in your child's bedroom.
    • Keep windows closed in car. Turn the air conditioner on recirculate.
    • Avoid window fans or attic fans. They pull in pollen.
    • Try to stay indoors on windy days. Reason: The pollen count is much higher when it's dry and windy.
    • Avoid playing with the outdoor dog. Reason: Pollen collects in the fur.
    • Pollen Count: You can get your daily pollen count from www.pollen.com.
      Just type in your zip code.
  9. Call Your Doctor If:
    • Symptoms are not better in 2 days after starting allergy medicine
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/14/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.